Dysrhythmia

109. A client has been admitted to the coronary care unit. The nurse observes third-degree heart block at a rate of 35 bpm on the client's cardiac monitor. The client has a blood pressure of 90/60. The nurse should take which of the following actions first? 1. Prepare for transcutaneous pacing. 2. Prepare to defibrillate the client at 200 J. 3. Administer an IV lidocaine infusion. 4. Schedule the operating room for insertion of a permanent pacemaker.

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108. When teaching a client about self-care following placement of a new permanent pacemaker to the left upper chest, the nurse should include which information? Select all that apply. 1. Take and record daily pulse rate. 2. Avoid air travel because of airport security alarms. 3. Immobilize the affected arm for 4 to 6 weeks. 4. Avoid using a microwave oven. 5. Avoid lifting anything heavier than 3 lb (1.36 kg).

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111. An older adult is admitted to the telemetry unit for placement of a permanent pacemaker because of sinus bradycardia. A priority goal for the client within 24 hours after insertion of a permanent pacemaker is to: 1. Maintain skin integrity. 2. Maintain cardiac conduction stability. 3. Decrease cardiac output. 4. Increase activity level

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112. The client who had a permanent pacemaker implanted 2 days earlier is being discharged from the hospital. The client understands the discharge plan when the client: 1. Selects a low-cholesterol diet to control coronary artery disease. 2. States a need for bed rest for 1 week after discharge. 3. Verbalizes safety precautions needed to prevent pacemaker malfunction. 4. Explains signs and symptoms of myocardial infarction (MI).

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114. Upon assessment of third-degree heart block on the monitor, the nurse should first: 1. Call a code. 2. Begin cardiopulmonary resuscitation. 3. Have transcutaneous pacing ready at the bedside. 4. Prepare for defibrillation.

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110. A client is scheduled for the insertion of an implantable cardioverter-defibrillator (ICD). The spouse expresses anxiety about what would happen if the device discharges during physical contact. The nurse should tell the spouse: 1. Physical contact should be avoided whenever possible. 2. They will not feel the countershock. 3. The shock would be felt, but it would not cause any harm. 4. A warning device sounds before countershock, so there is time to move away.

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